MINI SUSAN MAMMEN

GREAT NECK, NY
NPI1780241398
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NY  F344251)
Additional Taxonomies364SF0001X Clinical Nurse Specialist, Family Health
(Licence: NY  F344251)
Enumeration Date2019-05-20
Last Update Date2019-11-11
Business Address
MINI SUSAN MAMMEN
310 E SHORE RD
GREAT NECK, NY 11023-2410
Phone number: 516-482-8657
Mailing Address
MINI SUSAN MAMMEN
475 BEECH ST
NEW HYDE PARK, NY 11040-3825
Phone number: 718-598-0529